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In a clinical trial, diagnostic testing of suspected cases e.g RT-PCR for severe acute respiratory SARS-CoV-2, can be triggered by the presence of any COVID-19 associated symptom.
A household survey in the United Kingdom (UK) showed that fever, cough, anosmia, and ageusia were present on the day of testing in only 60% of symptomatic, RT-PCR positive individuals, implying that other less specific signs/symptoms associated with COVID-19 occur in a substantial number of patients.
The signs/symptoms associated with COVID-19 are extensive and overlap with those of other common viral infections.
Diagnostic work-up following any COVID-19 associated symptom will lead to extensive testing, potentially overwhelming laboratory capacity whilst primarily yielding negative results. We aimed to identify optimal symptom combinations to capture most cases using fewer tests with implications for COVID-19 vaccine developers across different resource settings and public health.
Methods
UK and US users of the COVID-19 Symptom Study app who reported new-onset symptoms and an RT-PCR test within seven days of symptom onset were included. Sensitivity, specificity, and number of RT-PCR tests needed to identify one case (test per case [TPC]) were calculated for different symptom combinations.
A multi-objective evolutionary algorithm was applied to generate combinations with optimal trade-offs between sensitivity and specificity.
Interpretation
We confirmed the significance of COVID-19 specific symptoms for triggering RT-PCR and identified additional symptom combinations with optimal trade-offs between sensitivity and specificity that maximize case capture given different resource settings.
read this paper at https://www.journalofinfection.com/article/S0163-4453(21)00079-7/fulltext
